Following an action-packed week for opioid-related legislation in the House, multiple Senate committees took up the mantle this week, hosting hearings, releasing new bills and considering legislation ahead of the Memorial Day recess. As bills advance out of committees, the full Senate is expected to consider the large package of opioid legislation later this summer. Meanwhile, similar efforts in the House are expected to make it to the floor in the coming weeks. The collective work of both chambers of Congress seek to address the opioid crisis from a number of fronts including prevention, treatment and recovery.

Despite the surging opioid crisis, only one in ten Americans with an addiction disorder receives treatment in any given year. Certified Community Behavioral Health Clinics (CCBHCs) were enacted in 2014 to fill the gaps in unmet need for addiction and mental health care and expand access to comprehensive, community-based treatment. Early results from the two-year program demonstrate how CCBHCs are dramatically improving access to opioid and other addiction care.

On Thursday, the Mental Health Liaison Group (MHLG) hosted a briefing for congressional staff on the need for more and clearer information regarding health information privacy laws, including the Health Information Portability and Accountability Act (HIPAA). The briefing brought together providers, consumers and family members to share stories about their interactions with health privacy laws, and in particular, to advocate for funding of the Compassionate Communication of HIPAA provisions authorized in the 21st Century Cures Act of 2016. The National Council is a leading and founding member of the MHLG and was pleased to have two members participate on the panel.

On Monday, the National Council submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding its proposed changes to the Medicaid access rule. The proposed changes would weaken the enforcement of federal requirements that ensure Medicaid enrollees have timely access to a variety of health care services. The National Council expressed strong opposition to these proposed changes as they would harm patients’ access to care for mental health and addiction services.

On Thursday, the House Energy and Commerce Committee reviewed remaining opioid legislation to be included in a large package aimed at addressing the opioid crisis, an effort which began last week in the full Committee. The Committee approved 32 bills, a week after approving another 25 opioid measures, bringing the total up to 57. Bills that advanced this week include provisions to loosen both the Institution for Mental Disease (IMD) rule on residential substance use disorder (SUD) treatment and privacy rules governing SUD treatment records, promote best practices for recovery housing and to ensure mental health and SUD parity in the Children’s Health Insurance Program (CHIP).

Last Friday, President Trump announced the Administration’s plan to lower drug prices in a speech entitled ‘American Patients First,’ which highlights steps the Administration has taken, outlines future actions, and requests public comment on “even bolder actions” to bring down drug prices. The wide-ranging proposals include reforms to Medicare Part D and Part B, Medicaid, the Food and Drug Administration (FDA), the 340B Drug Discount program, and more.

The House Committee on Ways & Means Wednesday approved seven bipartisan bills aimed at reducing opioid misuse and abuse in Medicare. The package would expand Medicare coverage of medication-assisted treatment (MAT), promote non-opioid alternatives for pain management and require Part D plans to have drug management plans for Medicare beneficiaries at risk of opioid addiction. The bills now move to the House floor, joining dozens of other opioid-related bills approved by the House Energy and Commerce Committee.

On Wednesday, the House Energy and Commerce Committee held its first of two hearings to consider a large package of legislation aimed at addressing the opioid crisis. The full Committee approved 25 of the 56 bills that had advanced from the Health Subcommittee, and is slated to review the remaining legislation next week with the hopes of advancing a comprehensive package to the House floor by Memorial Day. Bills that advanced this week included efforts to expand: telemedicine prescribing for medication-assisted treatment, student loan forgiveness for addiction treatment professionals and use of electronic health records by behavioral health providers.

A bipartisan bill that would incentivize behavioral health providers to adopt electronic health records (EHRs) has passed the Senate, and is onto the House for consideration. The Improving Access to Behavioral Health Information Technology Act (S. 1732), a National Council Hill Day 2018 ask, would incentivize behavioral health providers to incorporate electronic health records (EHRs) into their practices. A companion bill is also moving forward in the House as part of a large package of legislation to address the opioid epidemic.

On Tuesday, the House Energy and Commerce Health Subcommittee convened a hearing on 42 CFR Part 2 – regulations pertaining to the disclosure and sharing of a patient’s substance use treatment records. The bill in question, the Overdose Prevention and Patient Safety Act (H.R. 3545) intends to amend federal regulation related to substance use health records, aligning it with the Health Information Portability and Accountability Act or HIPAA, the law that governs privacy standards for other health care records. The Subcommittee is expected to vote on this legislation in the near future.

On Tuesday, May 8th, the National Council for Behavioral Health hosted briefings on Capitol Hill to highlight the importance of Mental Health First Aid training in helping communities respond to opioid overdoses and other substance use and mental health crises. The briefing introduced Congressional staff to Mental Health First Aid’s opioid overdose education and naloxone training component. The day’s panel included law enforcement, firefighters/paramedics and community educators from across the U.S. who discussed the impact that Mental Health First Aid has had on their communities and departments.

A little-known provision in the recent budget deal included new federal funding for social impact bonds (or pay-for-success contracts) that are meant to spur innovation and lower government spending. Social impact bonds are financing program contracts where privately funded initiatives receive government spending only if the program achieves its targeted outcomes. Social impact bonds are used in behavioral health care to improve clinical outcomes, yield savings and share risk in financing new approaches to treatment.

Last week, several federal agencies issued guidance to enhance the enforcement of the federal parity law, which requires that insurance coverage of mental health and addiction services be equal to medical/surgical health services. The new guidance is the result of requirements included in the 21st Century Cures Act to improve behavioral health coverage. The guidance released by Health and Human Services (HHS), Departments of Labor and Treasury is intended to help employers and insurers implement parity, improve the coordination of parity enforcement between the agencies and to provide Congress with recommendations for improving parity compliance moving forward.